Antibiotics for inflammation of the prostate are necessary. If the disease is left untreated, the chances of impotence, infertility, sclerosis, adenomas, and glandular abscesses increase.
When and why antibiotics are needed for prostatitis
The bacterial form of the pathology is found in about 12-18% of patients. An acute process is diagnosed in 5-9 out of 100 men aged 22-45 years, a chronic sluggish course - in 8-11% of patients.
The main task of antibiotic treatment is to suppress the activity of pathogenic microbes. They relieve inflammation, pain, normalize the functions of the gland, improve the flow of urine and blood circulation.
The diagnosis is based on:
- Laboratory tests that confirm the presence of bacteria in semen, urine, prostate secretions;
- characteristic symptoms;
- Signs of inflammation reflected in changes in the composition of the urine and blood.
Important factors when choosing an antibiotic
It is impossible to say which antibiotic is the best. Bacterial inflammation in prostate tissue is caused by many disease-causing organisms, so one drug can be effective against one species and not useful against another.
Only an antibiotic, selected taking into account certain factors, will have a positive therapeutic effect:
- Type of pathogen (determined by bacteriological analysis of microflora);
- the sensitivity of the identified bacteria to certain antibiotics.
The causative agents of bacterial prostatitis can be:
- typical gram-negative pathogens Escherichia coli (Escherichia coli) and Pseudomonas aeruginosa (Pseudomonas aeruginosa) - 55-80%;
- Enterobacteriaceae (Enterobacteriaceae) - 10-30%;
- fecal enterococci (Enterococcus faecalis) - 5-10%;
- atypical pathogens - chlamydia (chlamydia) - 36%, Trichomonas - 11%;
- Ureaplasma (Ureaplasma) and Mycobacteria (Musoplasma) - 20%.
- rarely detected pathogens - gonococci, fungi, Proteus, Klebsiella, gram-positive bacteria - staphylococci and streptococci.
In order to precisely identify the pathogen, bacteriological vaccination or a more informative method of DNA diagnostics - PCR (polymerase chain reaction) - is carried out.
When choosing a drug, consider:
- Spectrum of action - the number and types of pathogens that a particular antibiotic can suppress;
- the ability of a drug to accumulate in the prostate and maintain the desired concentration;
- long-term antibacterial effect;
- Side effects and contraindications;
- Method of drug administration;
- Path and speed of elimination from the body;
- Dosages and combinations of drugs;
- the ability to combine the drug with other drugs and methods of therapy;
- previous antibiotic treatment (start and duration);
Groups of effective antibiotics and prescription functions
In order for the antibiotic to penetrate the gland easily, it must be fat soluble, bind weakly to blood proteins, and be active in an alkaline environment.
Aminopenicillins
Today, preference is given to protected penicillins that are resistant to the destructive effects of enzymes - b-lactamases, which are secreted by the cocci flora. Penicillins are more effective in combination with clavulanic acid.
This group of antibiotics works better with an acute uncomplicated process and rare exacerbations of a chronic form of the disease, when typical causative agents of the pathology are identified. They do not suppress chlamydia, mycoplasma and enterobacteria.
Possible side reactions:
- Nausea;
- Diarrhea;
- allergic rashes;
- Itching;
- People with a propensity for drug allergies may experience allergic shock.
Cephalosporins
They act on many pathogens, but not for long. Effective in acute prostatitis. They accumulate poorly in the tissues of the prostate, so in a chronic process they are used for a short time as a "shock" group with an antibiotic effect.
Staphylococcal flora and clostridia are resistant to cephalosporins.
The drugs are considered to be of low toxicity; the only absolute contraindications are individual intolerance to cephalosporins.
If the disease progresses seriously or if patients have recently been treated with antibiotics, they resort to cephalosporins in combination with aminoglycosides.
Fluoroquinolones
They have a strong and long-term effect on most typical and atypical bacteria, including Pseudomonas aeruginosa (Pseudomonas aeruginosa), mycoplasma, chlamydia. Fluoroquinolones form a high concentration in prostate tissue and are therefore considered the drugs of first choice for treating a chronic process, except in cases where there is a suspicion of resistance to pathogens. Their effectiveness in suppressing microorganisms is 65-90%.
Due to the prolonged effect, fluoroquinolones are taken 1-2 times a day. Not prescribed for epilepsy, adolescent boys under 15-16 years of age. The doses are adjusted in men with heart and kidney disease and in those receiving antidepressants.
The drugs are usually well tolerated. In rare cases, note:
- Rash;
- Itching;
- Swelling of the vocal cords;
- Stomach pain;
- Nausea;
- Diarrhea;
- Insomnia;
- Nervousness;
- Photosensitization (sensitivity of the skin to the sun) under UV radiation.
Macrolides
The active ingredients accumulate in the affected prostate tissue. Macrolides are often prescribed in the acute form without complications and in the chronic course of the disease. A high activity of macrolides is observed in prostatitis caused by chlamydia. However, they do not suppress the typical pathogen of the pathology - Escherichia coli, and atypical microorganisms - mycobacteria, clostridia, enterococci.
Side effects are rare, more common in patients who are intolerant to this group of antibiotics, or who have severe liver or kidney damage. Occur rarely:
- Nausea;
- Heartburn;
- Dysbiosis;
- Hives;
- Diarrhea.
Aminoglycosides
Gentamicin has many contraindications and often causes side effects. It is prescribed to patients with an acute course of the disease. The drug quickly suppresses the activity of most types of pathogens, including atypical forms, fungi and mutated microbes that are insensitive to other groups of antibiotics.
In the chronic course of bacterial prostatitis, aminoglycosides are not prescribed due to low accumulation (accumulation) in the prostate tissue. The body slowly gets used to gentamicin.
The remedy is contraindicated in:
- increased response to aminoglycosides;
- severe renal impairment;
- Do not lie;
- Parkinsonism;
- hard of hearing;
- Dehydration.
Nausea, anemia, epilepsy, drowsiness, and impaired kidney function can occur.
Ansamycine
They have a broad spectrum of activity against microbes. The drugs are selected for severe prostatitis with tuberculous mycobacterium (Koch's bacillus) - Mycobacterium tuberculosis.
Tetracyclines
They have high natural activity against chlamydial and mycoplasma prostatitis. They accumulate in high concentrations in the tissue of the organ. Fecal enterococci are unresponsive to treatment with tetracyclines.
Now they are rarely prescribed because of their high toxicity, ability to penetrate the sperm and affect the male reproductive cells. After the end of therapy, 3-4 months should pass before conception.
Side effects: intestinal diseases, nausea, deterioration in liver function, allergic reactions, candidiasis.
Combined treatment
If the prostatitis is caused by Trichomonas, Ureaplasma, or Mycobacteria, a combined treatment regimen will be developed. It provides a combination of several drug groups.
Local treatment
Suppositories for bacterial inflammation in the prostate are prescribed to increase the effectiveness of the treatment. The administration of antibiotic suppositories has the following advantages:
- rapid penetration into the tissues of the gland through the intestinal wall;
- maximum accumulation of the drug in the gland;
- a minimum of side effects, since the drug is concentrated in tissues, almost without entering the general bloodstream;
- low dosages;
- low number of contraindications, easy application.
The indications for the use of antibacterial suppositories are similar to those for other medicinal forms - tablets, capsules, injections.
Suppositories contain fewer antibiotics than tablets and solutions, so their use is longer.
List of the most commonly prescribed suppositories:
- Suppositories with framycetin (aminoglycosides).
- Suppositories with erythromycin (macrolides).
- Chloramphenicol suppositories (active ingredient - chloramphenicol).
- Suppositories with rifampicin are effective, which quickly penetrates the gland and destroys most of the microbes. Treatment for tuberculous prostatitis lasts 6-9 weeks.
General principles of application
At home, you need to follow the principles of using antimicrobial drugs.
- Strictly adhere to the prescribed dosages, adhere to the regimen and regimen of therapy if a combination of drugs is prescribed.
- The course of therapy must be fully completed. If you interrupt the flow of drugs into the prostate tissue, the acute process quickly turns into a chronic one. The remaining microorganisms will continue to work "underground" and develop antibiotic resistance.
- The standard duration of treatment is at least 8-12 days in the acute phase and up to 6 weeks in the chronic phase.
- If the pain and temperature do not subside after 3 days of treatment in the acute phase, you must come to the doctor's appointment.
The treatment regimen for prostatitis is developed taking into account many factors. An antibiotic that works in one patient may not work in another.